Menstruation

2) Ovulatory Phase (Ovulation)

-day 14 *ovulation*: LH level peaks, causing rupture of the follicle and *release of the egg* near a fallopian tube -a woman is most likely to become pregnant on the 3 days before or on the day of ovulation -during ovulation some women experience "mittelschmerz" (middle pain) on the side of the abdomen where the egg has been released -release of the egg; high estrogen levels inhibit (restrains) the production of FSH; high estrogen levels trigger the hypothalamus to produce LH-releaser which triggers the pituitary to produce LH (lutenizing hormone). High estrogen also stimulates the lining of the uterus (endometrium) to thicken and form glands. Mittelschmerz.--(women who can feel themselves ovulating)

3) Luteal Phase

-day 15 to end -LH stimulates follicle to turn into corpus luteum (glandular mass of cells). Corpus luteum releases progesterone which inhibits the production of LH. Progesterone also contributes to build up of uterine lining. If egg is not fertilized, corpus luteum degenerates and estrogen and progesterone levels drop. If egg is fertilized, hormone levels do not drop.

1) Follicular phase

-days 5-13 -low levels of estrogen and progesterone cause the hypothalamus to stimulate the pituitary gland to secrete follicle-stimulating hormone (FSH) -this causes the ovaries to increase estrogen production and bring several follicles and their eggs to maturity -estrogen stimulates development of the endometrium (uterine lining) in order to receive a fertilized egg -estrogen also signals the pituitary to stop producing FSH and to start producing luteinizing hormone (LH) -the LH suppresses development of all but one follicle and egg

Who should take HRT?

-depends on each woman's evaluation of benefits and risks given her personal and family medical history -advised to take shortest time with lowest dosage possible -women should DEF not take if they are at risk or have history for heart disease, stroke, cancer, liver disease, or diabetes -women have less chance of heart disease than men-->until they get to menopause -women who have had breast cancer cannot take HRT

Menorrhagia

-excessively heavy blood flow

most common menopause symptom

-hot flash -80% of women experience it -sudden feeling of heat that spreads over the body with sweating, usually lasts 5 minutes and may occur several times a day

physical symptoms of menopause

-hot flashes, headaches, dizziness, heart palpitations, joint pain; -vaginal changes (becomes less acidic; less lubrication; less elastic (called senile vagina).—can effect intercourse, make it painful, can develop UTI's -Breasts because less firm; tissue replaced by fat -Redistribution of fat—goes to waistline/hips

Menstruation

-involves the release of a mature egg or ovum from its surrounding capsule or follicle -the cycle occurs in 4 phases, averages 28 days in length -governed by a feedback loop that involves 2 brain structures 1) the hypothalamus and the pituitary gland 2) the ovaries and the uterus

Hormone Replacement Therapy (HRT)

-medical treatment that replaces hormones in women whose levels drop after menopause -women who have had their uterus removed can take estrogen alone whereas those who still have their uterus are advised to take a combo of estrogen and synthetic progesterone in order to be protected against uterine cancer -the combined estrogen-progestin pill relieves the menopausal symptoms of hot flashes, night sweats, insomnia, and vaginal dryness -helps prevent osteroporosis and reduces risk of colon cancer -however, risk of causing heart attack, stroke, breast/ovarian cancer, etc. -women who started taking it early in menopause have less risk than those who begin 10-15 years later

Attitudes toward menstruation

-menstruation has had "bad press" throughout history -has been viewed as having magical and often poisonous powers -menstruating women have been isolated and forbidden to prepare food or engage in sexual activity -menstrual myths and taboos still exist although in a somewhat less extreme form -many Americans believe that a woman cannot function normally when menstruating, but there is little evidence that it effects anything -negative attitudes towards menstruating women remain strong -some women found redeeming features like maternal, strong, and trustworthy

attitudes toward menopause

-negative, especially among younger pre-menopausal women -some see it as a positive life change and are excited for no menstruation or child-bearing worries -better educated women held more positive views -black women most positive -asian americans least positive

Dysmenorrhea

-painful menstruation -caused by *prostaglandins*: hormone-like chemicals secreted by the uterine lining and other tissues as menstruation approaches; these substances cause uterine contractions, decreased blood flow, and increased sensitivity to pain, which lead to cramping -painful abdominal cramps and lower back pain -higher levels of pain are more likely to report high levels of psychological stress and poorer health -more likely to smoke and consume alcohol

psychological reactions to menopause

-popularly believed that menopausal women are more likely to display such psychological symptoms as depression, irritability, or mood swings -no evidence that these are associated with hormone levels during menopause -they may feel tired but this might be linked to disruptions in sleep caused by hot flashes -in fact, majority of women report post-menopause that the happiest and most fulfilling time of their lives was between 50-65

PMM

-premenstrual magnification of ongoing moods -at ovulation

PMS

-premenstrual syndrome -symptoms so severe that their normal functioning is impaired for a week each month preceding menstruation -back pains, bloating, cravings

women-as-problem bias

-psychologists' preference for studying negative aspects of women's lives rather than positive ones -findings that menstruation actually has some positive aspects did not generate a lot of media publicity

4) Menstruation

-shedding of uterine lining (4 tablespoons); -day 1 of menstruation is day 1 of cycle. (so days 1-4) -occurs when the low levels of estrogen and progesterone can no longer maintain the uterine lining, which is shed and exits through the cervix and vagina as menstrual flow -the low hormone levels trigger the beginning of another cycle -if the egg is fertilized, the hormone levels remain high, and a new cycle does not occur

Alternatives to HRT

-taking synthetic estrogen -certain antidepressants can reduce hot flashes -lifestyle modifications such as exercise and diet *phyto-estrogens*: plant foods do not contain estrogen but affect the body in a similar manner

perimenopause

-the 5-7 years preceding the beginning of menopause marked by increasing irregularity of the menstrual cycle and variations in the amount of menstrual flow

Amenorrhea

-the absence of menstruation -2 kinds: *1) primary:* never menstruated by the age of 18 *2) secondary:* has menstruated at least once before the age of 18 but for whatever reason no longer is

menarche

-the first period -this average age has decreased, tends to correlate with mother/siblings menstruation

Endometriosis

-when the lining of the uterus develops somewhere else; women who have this their periods are excruciating -can get laser surgery

4 Phases of Menstrual Cycle

1) Follicular phase (days 5-13) 2) Ovulation (day 14) 3) Luteal Phase (day 15-end) 4) Menstruation

Negative feedback loop

Hypothalamus-->Pituitary-->Ovaries-->Estrogen and Progesterone

Anovulatory cycle

menstruation without ovulation; menopause and menarche have highest occurence

climacteric

-15-20 year span of time during which a woman's body changes from being able to reproduce to not being able to reproduce

PMDD

-Premenstrual Dysphoric Disorder -most severe form of PMS -to be diagnosed with this, a woman must experience at least 5 symptoms during the week before her menstrual period, including depression, anxiety, mood swings, or anger/irritability -symptoms must interfere with work or social relationships and must be present only in the premenstrual phase of the cycle

Menopause

-cessation of menstrual periods for a full year -humans are only species that go through this -occurs because of the decline in the number of ovarian follicles (egg-producing cells), which results in a decline in the production of both estrogen and progesterone -avg age is 51 -if you smoke/drugs then can bring it on a year or two earlier -diets high in red meat and alcohol tend to delay menopause -vegetarian tend to experience it earlier -During menopause, pituitary continues normal production of FSH and LH, but ovaries lose their ability to respond to these hormones -bones become more brittle -all women experience vaginal changes its just a matter of degree